Captopril and Hydrochlorothiazide

ACE Inhibitor · ACE inhibitor/Thiazide diuretic

Indications

Mild to moderate hypertension.

Dosage

Adults: 1 tab daily. Max 2 tab daily. Children: Not recommended.

Adverse Effects

Captopril: Neutropenia, agranulocytosis, proteinuria, angioedema, pancreatitis, tachycardia, angina, anorexia, drowsiness, headache, paraesthesia, hepatic failure, hypotension, rash, loss of taste, cough (rare), sleep disorders, dizziness, dyspnoea, GI upset, dry mouth, pruritus, alopecia, blood dyscrasias. Hydrochlorothiazide: Anorexia, epigastric distress.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Captopril: Aortic stenosis. Renal impairment, angioedema, history of angioedema associated with previous ACE inhibitor therapy. Hydrochlorothiazide: Anuria, renal decompensation. Precautions: Captopril: Collagen vascular disease, anaesthesia, diabetes. Elderly. Salt or volume depletion; correct before commencing therapy with a lower dose, aortic and mitral valve stenosis, outflow obstruction, renovascular hypertension, severe CHF, haemodialysis, renal impairment; monitor renal function, serum electrolytes, white cell count and urinary protein before and during therapy. Hydrochlorothiazide: Avoid in severe renal disease. Gout, diabetes, patients with moderate to high cholesterol concentrations.

Interactions

Captopril: K+ sparing diuretics or K+ supplements, NSAID, vasodilators, clonidine, allopurinol, procainamide, probenecid, immunosuppressants, other antihypertensives, trimethoprim, heparin, lithium, antidiabetic agents, TCADs, antipsychotics, sympathomimetics, hyposensitising agents, anaesthetics, high flux dialysis memebranes, alcohol. Hydrochlorothiazide: Beta-blockers, ACE inhibitors, neuromuscular blocking agents, oral hypoglycaemics, NSAIDs.

Pharmacokinetics

CAPTOPRIL: Onset of action: Within 15 min. Peak effect: Blood pressure reduction: 1-1.5 hrs after dose. Max effect: Antihypertensive: 60-90 min. Duration: Dose related. Absorption: 60%-75%; rapid. Bioavailability: Approx. 60%-75%; decreased 30%-40% by food. Metabolism: 50% metabolized. Half-life elimination: Infants with CHF: 3.3 hrs. Children: 1.5 hrs. Adults (healthy): Approx. 1.7 hrs. Time to peak: Within 1-2 hrs. Excretion: Urine (>95%) within 24 hrs. HYDROCHLOROTHIAZIDE: Onset of action: Diuresis: Infants: 2-6 hrs. Adults: Approx. 2 hrs. Peak effect: 4-6 hrs. Duration: Infants: 8 hrs. Adults: 6-12 hrs. Absorption: Well absorbed, absorption is decreased in patients with CHF. Metabolism: Not metabolized. Bioavailability: 65%-75%. Half-life elimination: Approx. 6-15 hrs. Time to peak: Approx. 1-5 hrs. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.